Why are older people happier with the NHS?

Our analysis of generational opinions doesn’t always show such clear-cut distinctions between each different cohort – and sometimes one generation stands out as distinct. But that can be equally important in understanding recent trends and the future for services.

For example, the chart above breaks down trends in satisfaction with the NHS between generations. The first point to note is that the generations do generally follow a similar trend – there are undulations in the 1980s and 1990s, and then a sustained increase in satisfaction across each generation as health service funding increased in the 2000s.

But the other point that clearly stands out is how different the pre-war generation is from the rest – they are significantly more satisfied than following generations at each point, at least since the late 1980s. This gap remains pretty consistent, which suggests that being old in itself is not the primary explanation (we would expect the gap to increase if that was the case, as more of the pre-war generation entered into this older group).

Instead it suggests the importance of growing up when the NHS was being founded and first delivered. This in turn could be due to pride in its institution, or memory of what it was like before it existed.

It has often been observed that the oldest age groups are happier with many aspects of public services,1 and one possible explanation suggested is that people expect less as they move into this group.

...as the composition of the population changes, we may see one older population being replaced by one that is a lot less grateful.

The trends seen here on the NHS suggests that this lifecycle effect may turn out to be less important and that it’s a cohort effect that drives this pattern, in the case of health services at least. This is important to understand: as the composition of the population changes, we may see one older population being replaced by one that is a lot less grateful.

1 See for example the Frontiers of Performance series of reports by Ipsos MORI on local council, health and housing services. www.ipsos-mori.com